纽约时报双语版-中国新型冠状病毒疫情的未知问题

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As New Virus Spreads From China, Scientists See Grim Reminders

中国新型冠状病毒疫情的未知问题

纽约时报双语版-中国新型冠状病毒疫情的未知问题

印度加尔各答,对来自中国的旅客用热像仪检查冠状病毒感染的迹象。
Indian Ministry of Civil Aviation, via Agence France-Presse — Getty Images

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Less than a month after the first few cases of a new respiratory illness were reported in Wuhan, China, travelers have carried the virus to at least four other countries, including the United States. More than 500 people have been infected, at least 17 have died — and the world is bracing itself for what might come next.

中国武汉报告了最初几例新型呼吸道疾病病例不到一个月后,旅行者已将病毒携带到了包括美国在内的至少四个其他国家。已有超过500人感染,至少17人死亡——世界正在为未来可能发生的情况做准备。

On Wednesday, experts at the World Health Organization decided to postpone until Thursday a decision on whether the current outbreak constitutes a “public health emergency of international concern,” a label given to “serious public health events that endanger international public health” and “potentially require a coordinated international response.”

周三,世界卫生组织的专家决定把当前疫情是否构成“国际关注的突发公共卫生事件”的决定时间推迟到周四,该称呼指的是“危及国际公共健康的严重公共卫生事件”,“可能需要采取协调一致的国际应对措施”。

Public health officials around the world are on alert because the new infection is caused by a coronavirus, from the same family that caused outbreaks of SARS and MERS, killing hundreds of people in dozens of countries.

世界各地的公共卫生官员已处于警戒状态,因为这种新型传染病是由一种冠状病毒引发。来自同一家族的冠状病毒曾引发过严重急性呼吸综合征(简称SARS)和中东呼吸综合征(简称MERS)等较严重的疾病,在几十个国家造成数百人死亡。

The W.H.O. has already advised governments to be prepared for the disease, to be vigilant and ready to test anyone with symptoms like cough and fever who has traveled to affected regions. Air travel is expected to surge as the Lunar New Year approaches this weekend.

世卫组织已建议各国政府做好应对这种新型疾病的准备,提高警惕,随时准备对去过受感染地区、有咳嗽和发烧等症状的人进行检查。随着本周末农历新年的到来,航空旅行人数预计将大幅增长。

Several countries have already begun screening travelers from China for fever and cough. Airports in Los Angeles, New York and San Francisco last week started to screen arriving flights from Wuhan, and airports in Atlanta and Chicago will begin doing so this week.

一些国家已开始对来自中国的旅客进行发烧和咳嗽筛查。洛杉矶、纽约和旧金山的机场上周开始对来自武汉的航班进行检查,亚特兰大和芝加哥的机场本周也将开始这样做。

But important questions about the outbreak are still unanswered, and W.H.O.’s expert committee now must grapple with significant unknowns.

但是,关于这次疫情爆发的重要问题仍未得到解答,世卫组织的专家委员会现在必须努力设法解决这些重要的未知问题。

“We don’t know how many people are infected,” said Tarik Jasarevic, a spokesman for the W.H.O. “The more you test, the more you will find people who are infected. We don’t know if there are asymptomatic cases. If they are asymptomatic, are they contagious?”

“我们不知道有多少人受感染,”世卫组织发言人塔里克·亚沙雷维奇(Tarik Jasarevic)说。“接受检查的人越多,你将发现的感染者也越多。我们不知道是否有无症状的病例。如果他们没有症状,会传染吗?”

Broad studies to test for evidence of infection, past and present, would give a true picture of how many people have been exposed to the virus.

对过去的和现在的感染证据进行广泛研究,可以给出有多少人接触过这种病毒的真实情况。

“Testing is possible because China immediately shared the genetic sequence of the virus, and we have to give them credit for that,” Mr. Jasarevic said.

“检查是可能的,因为中国立刻分享了这种病毒的基因序列,我们必须表扬中国做的这一点,”亚沙雷维奇说。

The virus causes a pneumonialike illness, with coughing and fever in some people but not all. The severity matters: If there are cases with mild illness or no symptoms at all, they may go undetected, and those people will keep working, shopping and traveling, possibly infecting others.

这种病毒会引起类似肺炎的疾病,症状包括咳嗽,部分感染者会发烧。症状的严重程度很重要:如果有些受感染者只有轻微症状或根本没有症状的话,他们可能不会被发现,这些人将继续工作、购物和旅行,从而可能传染其他人。

A milder illness has the potential to spread farther and cause longer-lasting outbreaks than one with more obvious symptoms, according to Dr. Mark R. Denison, an infectious disease specialist at the Vanderbilt University School of Medicine who studies coronaviruses.

范德比尔特大学医学院(Vanderbilt University School of Medicine)研究冠状病毒的传染病专家马克·R·丹尼森(Mark R. Denison)博士说,与症状更明显的疾病相比,症状较轻的疾病有可能传播得更远,引发持续时间更长的疫情。

Compared to SARS and MERS, the Wuhan illness so far does seem less severe, he said.

他说,与SARS和MERS相比,武汉肺炎到目前为止确实看来不是那么严重。

SARS, which began in live-animal markets in China in 2002, quickly spread to dozens of countries, infecting more than 8,000 people and killing nearly 800. The virus is thought to have originated in bats and spread to civet cats that were being sold for consumption.

2002年,非典在中国销售活动物的市场爆发,很快蔓延到几十个国家,感染了8000多人,导致近800人死亡。SARS病毒被认为起源于蝙蝠,后来传播到出售的供食用的果子狸身上。

The civets spread the virus to humans, who infected one another through respiratory secretions and also exposure to feces.

果子狸将病毒传播给人类,该病毒通过呼吸道分泌物以及粪便进行人际感染。

SARS often caused severe illness, so cases were detectable; aggressive public health measures, including quarantines and travel restrictions, helped stamp out the epidemic.

SARS病毒通常引发严重的疾病,因此病例可以检测到;积极的公共卫生措施,包括隔离和旅行限制,帮助消灭了这种流行病。

纽约时报双语版-中国新型冠状病毒疫情的未知问题

周二抵达洛杉矶机场的中国旅客。洛杉矶、纽约和旧金山的机场上周开始对来自武汉的航班进行检查,亚特兰大和芝加哥的机场本周也将开始这样做。
Alex Welsh for The New York Times

But the travel bans, not to mention widespread fear and distrust, took a heavy economic toll on China, and since then international authorities have become hesitant about taking drastic steps to quell outbreaks.

但这些旅行禁令,更不用提普遍存在的恐惧和不信任,给中国带来了沉重的经济损失,自那以后,国际上的有关部门对采取激烈措施来平息疫情变得犹豫不决。

MERS cases have been occurring in the Middle East since 2012, mainly in people who have been exposed to camels, which were most likely infected by bats. Human-to-human transmission does occur, and some spread has happened in hospitals.

自2012年以来,中东地区一直有MERS病例出现,主要是在与骆驼有过接触的人群中,骆驼最有可能是被蝙蝠感染的。人与人之间的传播也有发生,医院里也发生过交叉感染。

As of November, there had been 2,494 cases of MERS in the last seven years, mostly in Saudi Arabia. The death rate is 34 percent, but may actually be lower if there are mild cases of the disease that have not been detected or counted.

截至去年11月,在过去7年里共发生了2494例MERS病例,主要是在沙特阿拉伯。这种疾病的死亡率是34%,但如果一些症状轻微的病例被发现或统计进来,实际死亡率也许会低一些。

Dr. Denison described the new Wuhan coronavirus as “sort of a first cousin of SARS,” more closely related to it than to MERS, based on its genetic sequence.

丹尼森将这种新型的武汉冠状病毒描述为“SARS的某种近亲”,根据基因序列,新型病毒与SARS的关系比其与MERS的更近。

Researchers do not know just how contagious the Wuhan coronavirus is. The first people to be infected are thought to have contracted it at a market in Wuhan that sold meat, fish and live animals.

研究人员还不知道武汉冠状病毒的传染性有多强。第一批受感染者被认为是在武汉的一个出售肉、鱼和活体动物的市场上感染的。

That market has been shut down and disinfected. Which animal might have been carrying the virus is not yet known.

那个市场已经关闭并进行了消毒。目前还不清楚哪种动物可能携带了这种病毒。

Initially, the illness appeared to spread only from animals to people. Then, experts said there was evidence of “limited” human-to-human transmission. Now, more cases are emerging among people with no known exposure to the animal markets, and in medical staff members caring for infected patients.

最初,这个疾病似乎只是从动物传染到人。后来,专家们说,存在“有限”人际传播证据。现在,更多的病例已在没有接触过动物市场的人群,以及护理过感染者的医务人员中出现。

“Now that you have a cluster of 14 health care workers infected, it suggests that the potential for spread is much greater,” said Dr. Ian W. Lipkin, director of the Center for Infection and Immunity at Columbia University’s Mailman School of Public Health in New York, who has researched SARS and MERS.

“现在已有一个14名医护人员的群体被感染,这表明疾病扩散的可能性更大了,”纽约哥伦比亚大学梅尔曼公共卫生学院的传染病与免疫研究中心主任伊恩·W·利普金(Ian W. Lipkin)博士说,他研究过SARS和MERS。

“I saw film footage of a hospital lobby in Wuhan, and they are wearing full personal protective equipment from head to toe,” he said. “They are taking it very seriously. I still don’t think this is as bad as SARS, but it’s worse than they originally portrayed it.”

“我看到了一个武汉一家医院大厅的监控录像,医护人员穿着从头到脚的全套个人防护装,”利普金说。“他们在非常认真地对待这件事。我仍然认为这个病毒没有SARS那么糟糕,但比他们最初描述的要糟。”

Dr. Denison said that with both SARS and MERS, there were episodes in which individual patients became “super-spreaders” who infected many other people, for unknown reasons.

丹尼森说,无论是SARS还是MERS,都有个别病人感染了许多其他人,成为“超级传播者”的情况发生,但原因不明。

“That’s a wild card we don’t know, the capacity to have multiple transmissions from one person,” Dr. Denison said. “There was no evidence they had dramatically different virus.”

“一个人感染多人的能力,这是我们不知道的一个未知因素,”丹尼森说。“没有证据表明他们感染了极为不同的病毒。”

It is possible, he said, that super-spreaders had received a high dose of the virus and had more of it to transmit. Alternatively, their immune systems might have not been able to control the virus, allowing it to multiply and spread extensively in their bodies, making them more contagious.

他说,一种可能性是,超级传播者感染了高剂量的病毒,因此有更多的病毒可传播。另一种可能是,他们的免疫系统也许未能控制病毒,导致病毒在他们体内大量繁殖和传播,使他们更具有传染性。

Although no drugs have been approved specifically to treat coronavirus diseases, Dr. Denison said that in animal studies, an antiviral called remdesivir appeared effective. He has been working with other researchers to develop treatments.

丹尼森说,虽然还没有专门用于治疗冠状病毒疾病的获批药物,但在动物研究中,一种名为remdesivir的抗病毒药物似乎有效。他一直在与其他研究人员合作研究治疗方法。

Mr. Jasarevic said that antivirals were being tested against MERS, but that none had been approved yet.

亚沙雷维奇说,正在对抗病毒药物进行针对MERS的临床试验,但还没有药物获得批准。

How and why viruses that have peacefully coexisted with their animal hosts for a long time strike out for new territory — us — is not well understood.

长期与动物宿主和平共处的病毒为什么以及如何突然向新的宿主——我们——出击,人们对个问题还不太了解。

Coronaviruses often inhabit bats without harming them, and sometimes move into other animal species and from them to humans.

冠状病毒通常栖息在蝙蝠体内,但不会伤害它们,有时病毒转移到其他动物物种,然后从这些物种感染人类。

In places that bring multiple animal species together with lots of people — like the food markets in Wuhan and in other parts of China that sell live mammals and birds, along with meat and fish — viruses can pass back and forth between species, mutating as they go. Along the way, they may become able to infect humans.

在一些将多个动物物种和很多人带到一起的地方——比如武汉和中国其他地方出售活的哺乳动物和活禽,以及各种肉类和鱼类的市场——病毒可以在不同物种间来回传播,并在传播过程中发生变异。在这个过程中,它们可能会感染人类。

“Coronaviruses have repeatedly shown an ability to probe across species and cause new animal and human diseases,” Dr. Denison said.

“冠状病毒已经多次展现出跨物种探测,导致新的动物和人类疾病的能力,”丹尼森说。

To go successfully from animal hosts to people, the viruses need to adapt in several ways: They must gain the ability to invade human cells, evade the immune system, replicate inside the human body and spread to others.

要成功地从动物宿主转移到人类,病毒需要发生几个变异以适应新环境:必须获得入侵人类细胞的能力,必须能躲避人的免疫系统,能在人体内复制,并传播给他人。

The move is often described as “jumping” into humans, but that is an oversimplification, Dr. Denison said. “The process it has to go through is more like high hurdles with a thousand hurdles along the way,” he said.

丹尼森说,虽然人们用“跳到”人类身上来描述病毒的这种转移,但这个词过于简单化。“病毒转移必须经过的更像是一路要跨越1000个高栏的跨栏过程。”

Still, the new outbreak does not greatly surprise him: “This was a matter of not if, but when.”

尽管如此,新型冠状病毒的爆发并没有让他感到太惊讶:“这不是会不会的问题,而是什么时候发生的问题。”

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